http://www.med-ehub.comRSS Feed for Med~eHUB120http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/872/Default.aspxMedicaid Covered Outpatient Drugs NPRM (CMS-2345-P) Thursday, February 2, 2012, a Notice of Proposed Rulemaking (NPRM) titled “Covered Outpatient Drugs” (CMS-2345-P) will be published in the Federal Register. The NPRM went on display Friday, January 27, 2012. This NPRM implements Medicaid drug provisions of the Affordable Care Act and will increase transparency in drug pricing and save States and taxpayers money through a number of improvements, including: • Aligning reimbursement rates for all drugs closer to the actual price the pharmacy pays for the drug; • Increasing rebates paid by drug manufacturers that participate in Medicaid; • Providing rebates for drugs dispensed to individuals enrolled in a Medicaid managed care organization; and • Lowering reimbursement for certain generic drugs. Comments Due The NPRM will be open for public comment through April 2, 2012, and CMS encourages all interested parties and stakeholders to submit comments. Please contact us at Info@Med-eHUH.com for more information. Lisa BlantonWed, 01 Feb 2012 17:39:58 GMTd03a2b2f-601e-4149-a0da-781c803d35edhttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/871/Default.aspxThe FDA is soliciting comments on the Healthcare Professional Survey of Prescription Drug Promotion. This survey is designed to explore the opinions and perceptions of physicians, nurse practitioners, and physician assistants with regard to the promotion of prescription drugs to consumers and healthcare providers.Lisa BlantonMon, 16 Jan 2012 17:53:11 GMT9010b295-6923-464b-aae2-fb21f14baeeahttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/870/Default.aspx2012 User-fee agreement heads to Congress A final agreement between the FDA and the pharmaceutical industry on user fees for prescription, generic and biosimilar drugs was submitted for approval by Congress on January 16, 2012. Lisa BlantonMon, 16 Jan 2012 15:51:51 GMT094e4bba-10dd-43f7-baca-9d9b20252bd8http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/865/Default.aspxThe Food and Drug Administration (FDA) is announcing the availability of a guidance for industry entitled ‘‘Medication Guides— Distribution Requirements and Inclusion in Risk Evaluation and Mitigation Strategies (REMS).’’ Lisa BlantonFri, 18 Nov 2011 10:54:45 GMT3a4dd6cb-0b72-4142-9deb-49821e40e2bchttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/860/Default.aspxUpdate to the Medicaid Prescription Drug Policy & Reimbursement Federal Upper Limits is available. Please contact info@Med-eHUB.com for more information.Lisa BlantonThu, 22 Sep 2011 15:56:16 GMT9be3120c-5259-496e-b13e-d8a52e6174behttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/859/Default.aspxThe Food and Drug Administration has agreed to work toward faster, more predictable reviews of new prescription drugs in return for millions of dollars in additional fees from drugmakers, under a draft agreement unveiled by the agency on Thursday, September 1, 2011. A spokeswoman for the agency confirmed that the new agreement would raise fees about 6 percent, collecting an estimated $40.4 million in new revenue for fiscal year 2012. The deal comes after months of closed-door meetings between FDA and drug industry officials working to extend a two-decade old program that supplements the agency's budget with company fees. The latest agreement would require the FDA to provide more meetings and updates on the status of certain drug reviews. Some of the new revenue would also be invested in computers and technology, as well as a proposed system for tracking reports of drug side effects. The deal must be approved and drafted into law by Congress before it expires on Oct. 1 2012. Lawmakers already have granted three 5-year extensions to the program. Since it passed in 1992, the Prescription Drug User Fee Act has allowed the FDA to hire hundreds of additional scientists in return for meeting certain performance goals.Lisa BlantonThu, 01 Sep 2011 20:37:25 GMT0a5af587-c021-498b-abb7-24ffdf4aa259http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/856/Default.aspxOn August 12, the Centers for Medicare and Medicaid Services (CMS) and the Internal Revenue Service division of the Treasury Department issued coordinated regulations covering eligibility rules for Medicaid, CHIP, and subsidies for premium tax credits that will be available for Exchange based health coverage. The Medicaid regulation also codifies the new enhanced federal funding that will be available to states for covering individuals newly eligible for Medicaid. NAMD is reviewing the regulations and will disseminate our analysis to directors as soon as possible. Links to the regulations are available at www.Med-eHUB.com or email us at info@Med-eHUB.com for this and other Medicaid info.Lisa BlantonMon, 15 Aug 2011 19:57:23 GMTc417c859-3d52-4ef7-bc46-b040e3a4d237http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/855/Default.aspxInfluenza Virus Vaccine for the 2011 - 2012 Season Updated: 8/10/2011 Lisa BlantonWed, 10 Aug 2011 19:57:26 GMTdc98d278-3296-4927-a3f3-2f6975018f57http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/850/Default.aspxEarlier today the Department of Health and Human Services provided preliminary guidance to States on opportunities to align financing between Medicare and Medicaid to support improvements in the quality and cost of care for individuals eligible for both programs (“Medicare-Medicaid enrollees”). The Centers for Medicare & Medicaid Services has outlined two models to support State efforts to integrate care for Medicare-Medicaid enrollees. States will have an option to pursue either or both of these models. For more detailed information, please see the State Medicaid Director’s letter “Financial Models to Support State Efforts to Integrate Care for Medicare-Medicaid Enrollees” here at www.Med-eHUB.comLisa BlantonFri, 08 Jul 2011 19:41:38 GMT238d0a83-c0fe-4506-a1f7-c1d0878c0a5ahttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/849/Default.aspxSurvey Of Retail Prices: Payment And Utilization Rates, And Performance Rankings [PDF 23KB] SURVEY OF RETAIL PRICES: PAYMENT AND UTILIZATION RATES, AND PERFORMANCE RANKINGS - July 8, 2011 - CMS is pleased to announce that Myers and Stauffer, LC has been awarded contract number CMS-2011-ACA03 entitled "Survey of Retail Prices: Payment and Utilization Rates, and Performance Rankings." This contract was awarded after a thorough national search for a well-qualified vendor. The purpose of the Survey of Retail Prices is to develop a monthly survey of retail community pharmacy prescription drug prices and the generation of publicly available pricing files. We anticipate that these files will afford State Medicaid agencies with a valid array of covered outpatient drug information, regarding retail prices for the ingredient costs of prescription drugs and consumer purchase prices for such drugs. We expect that State Medicaid agencies will be able to use this information to compare their own pricing methodologies and payments to those derived from this survey. Additionally, on an annual basis, CMS will obtain from the State Medicaid agencies information on their prescription drug payment and utilization rates and prepare a comparative report regarding the performance of the States' reimbursement prices and the national retail price data collected in the survey.Lisa BlantonFri, 08 Jul 2011 15:32:40 GMTf4494e98-45c2-4289-a27a-59c6c72315abhttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/847/Default.aspxUnitedHealthcare sues Department of Defense June 22, 2011 MINNETONKA, MN – UnitedHealthcare is suing the Department of Defense over the loss of its TRICARE South Region contract. The health insurance company has been fighting for reinstatement of the contract it was originally awarded in 2009 but lost last February.Lisa BlantonMon, 27 Jun 2011 15:57:58 GMT21096451-f07b-4a4c-9bb5-5a580da40feehttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/846/Default.aspxSORRELL, ATTORNEY GENERAL OF VERMONT, ET AL. v. IMS HEALTH INC. ET AL. CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT No. 10–779. Argued April 26, 2011—Decided June 23, 2011 Link from www.Med-eHUB.com or email info@Med-eHUB.com for additional information.Lisa BlantonThu, 23 Jun 2011 16:05:49 GMT1e15c63a-1780-4d8b-87c6-4bf8d2fc881ehttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/842/Default.aspxAlso see Med-eHUB's page Legal Documents involved in PPACA Lawsuit or email us at info@Med-eHUB.com for additional info.Lisa BlantonWed, 08 Jun 2011 14:27:21 GMTd24b9d75-b6fe-4a79-8e55-20117341701fhttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/834/Default.aspxHouse Oversight and Government Reform Subcommittee on Health Care, District of Columbia, Census, and the National Archives Hearing "Pathway to FDA (Food and Drug Administration) Medical Device Approval: Is There a Better Way?" Testimony by Jeffrey ShurenLisa BlantonFri, 03 Jun 2011 19:52:01 GMT330f242b-4553-48ff-b46d-0e40f0c0d290http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/833/Default.aspxSUMMARY: This rule proposes to implement new statutory requirements regarding the release and use of standardized extracts of Medicare claims data to measure the performance of providers and suppliers in ways that protect patient privacy. This rule explains how entities can become qualified by CMS to receive standardized extracts of claims data under Medicare Parts A, B, and D for the purpose of evaluation of the performance of providers of services and suppliers. Contact Med-eHUB at Info@Med-eHUB.com for more information.Lisa BlantonFri, 03 Jun 2011 18:12:56 GMT5a5349bb-9264-4b24-a9b8-e35993806b61http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/828/Default.aspxTen Parent Companies with the Highest Medicare Advantage Contract Enrollment Questions? Ask Med-eHUB at info@Med-eHUB.comLisa BlantonThu, 26 May 2011 17:37:14 GMT0ffff61d-0772-43f2-a284-8559a37bd0bbhttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/824/Default.aspxwhat are the right questions about Medical Loss Ration (MLR)?Lisa BlantonMon, 25 Apr 2011 16:50:20 GMT50430956-ec92-4ec0-b23b-a6698d000878http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/823/Default.aspxThe legal fight over President Obama's health care overhaul will apparently go through normal legal channels after the Supreme Court on Monday announced it will not expedite a major lawsuit from Virginia challenging the controversial law. In his petition, Virginia Attorney General Ken Cuccinelli said there is a "palpable consensus" that the Supreme Court will ultimately be asked to decide whether the Affordable Care Act and its individual mandate is constitutional. While it's hard to predict the timeline of this case or the couple of dozen others working through the legal system, it's possible that the Virginia case or another could be heard by the court by this time next year with a ruling by the end of June 2012. Lisa BlantonMon, 25 Apr 2011 15:34:26 GMT889cbaa3-e26c-480c-b807-04f73c5878d8http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/821/Default.aspxPPACA: Related Health Care Compliance and Reimbursement Federal Register Issuances, ADVANCE RELEASE: Medicare Program; Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for the Contract Year 2012 and Other Changes dated 04/08/2011, (Apr. 15, 2011) is available. Please email us at info@Med-eHUB.com for a copy of this 327 page ADVANCE RELEASE report.Lisa BlantonFri, 15 Apr 2011 14:09:35 GMT7e6b9ee7-6ff9-4b2f-8165-00250917f346http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/820/Default.aspxGAO Report: State and Local Governments’ Fiscal Outlook April 2011 Update "The state and local government sector continues to face near- and longterm fiscal challenges that grow over time. The fiscal challenges confronting the state and local sector add to the nation’s overall fiscal difficulties. Although the sector’s near-term fiscal picture has improved slightly since our March 2010 update, the economic downturn has created an unprecedented fiscal situation for states as revenues declined in tandem with the economy. As we have reported in previous model updates, and as shown in figure 1, the sector faces long-term fiscal challenges that grow over time. The model’s simulations show that the fiscal position of the sector will steadily decline through 2060 absent any policy changes..." Get the Full Report at www.Med-eHUB.comLisa BlantonMon, 11 Apr 2011 17:04:48 GMT3d7dd7ea-cb56-47c8-bce3-8d4d91d22495http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/818/Default.aspxWhat's New This Week - Healthcare Lisa BlantonWed, 30 Mar 2011 19:07:35 GMTf8cb2596-31a7-4e2c-9df1-d76728898a07http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/804/Default.aspxPatient Protection and Affordable Care Act: Related Reports and Other Documents,Medicare payments for newly available generic drugs dated 01/01/2011,Centers for Medicare and Medicaid Services, (Jan. 17, 2011) Department of Health and Human Services OFFICE OF INSPECTOR GENERAL Medicare Payments for Newly Available Generic Drugs Daniel R. Levinson Inspector General January 2011 OEI-03-09-00510 The OIG is send a second warning to CMS that the two moth lag in ASP reporting is resulting in over-payments for newly available generics in Part B. See the letter here....Lisa BlantonMon, 17 Jan 2011 17:11:38 GMT9e335fc0-a42c-4120-9b4f-7d7b57ec63e6http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/801/Default.aspxThis Federal Register notice announces the monthly actuarial rates for aged (age 65 and over) and disabled (under age 65) beneficiaries enrolled in Part B of the Medicare Supplementary Medical Insurance (SMI) program beginning January 1, 2011. In addition, this notice announces the monthly premium for aged and disabled beneficiaries as well as the income-related monthly adjustment amounts to be paid by beneficiaries with modified adjusted gross income above certain threshold amounts. The monthly actuarial rates for 2011 are $230.70 for aged enrollees and $266.30 for disabled enrollees. The standard monthly Part B premium rate for 2011 is $115.40, which is equal to 50 percent of the monthly actuarial rate for aged enrollees or approximately 25 percent of the expected average total cost of Part B coverage for aged enrollees. (The 2010 standard premium rate was $110.50.) The Part B deductible for 2011 is $162.00 for all Part B beneficiaries. If a beneficiary has to pay an income-related monthly adjustment, they may have to pay a total monthly premium of about 35, 50, 65, or 80 percent of the total cost of Part B coverage.Lisa BlantonTue, 09 Nov 2010 15:19:01 GMTd5294f75-fb9e-4587-b34a-1b95820ca46fhttp://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/799/Default.aspxProvisions of the Patient Protection and Affordable Care Act passed by Congress March 23, also known as the health care reform law, go in effect today, Thursday, Sept. 23. The provisions now effective are: * Expansion of the dependent age up to 26 years. Until now, dependents were no longer covered by their parents’ or guardians’ insurance after 19 years of age, or if in college, after 23 years. * No annual or lifetime dollar limits to amount of money spent on health services. * No denying coverage to children under 19 years of age for preexisting conditions. * Coverage for all preventative services with no co-pays.Lisa BlantonFri, 24 Sep 2010 23:00:30 GMTe9375056-ecde-4aac-83c8-e4f04a2394e3http://www.med-ehub.com/WhatsNewatCMS/tabid/200/itemId/793/Default.aspxAnnouncement of Five New Members to the Advisory Panel on Ambulatory Payment Classification Groups - MedicareLisa BlantonFri, 20 Aug 2010 15:09:41 GMT17a4de96-6855-46be-af2d-4ac671637a63